Organization
GENESIS HEALTHCARE CENTER, INC
Active
Other names
genesis healthcare center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY L HENRY (PRESIDENT)
(818) 888-1616
Entity
Organization
Contact information
Practice address
1201 WALNUT AVE, LONG BEACH, CA 90813-3822
(562) 591-7621
(562) 591-3292
Mailing address
1201 WALNUT AVE, LONG BEACH, CA 90813-3822
(562) 591-7621
(562) 591-3292
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
940000173
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
940000173
LICENSE NUMBER
CA
Enumeration date
06/17/2010
Last updated
03/22/2011
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